Individual
ERIC JACKOWIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-5200
(414) 259-0469
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-5200
(414) 259-0469
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
72658
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972922706
—
WI
Enumeration date
04/09/2014
Last updated
07/01/2020
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